CMS misclassified readmission penalties for nearly a third of hospitals, study finds

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For the cross-sectional research study, the authors approximated the rate at which penalties were misclassified for healthcare facilities in the readmissions program for financial year 2019. The authors utilized 2014-17 information from CMS Hospital Compare site. The data consisted of info from 1,633 hospitals that discharged Medicare recipients with heart attacks, 2,626 healthcare facilities for heart failure and 2,705 health centers for pneumonia. This has crucial ramifications for CMS value-based programs that use risk-standardized outcomes to compare and evaluate medical facility efficiency.”.

Morgan Haefner –
Thursday, October 15th, 2020
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This has essential implications for CMS value-based programs that use risk-standardized outcomes to compare and examine hospital efficiency.”.

Penalties for as much as 31 percent of healthcare facilities in CMS Hospital Readmissions Reduction Program were misclassified last year, according to a study published in JAMA Cardiology.

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For the cross-sectional study, the authors approximated the rate at which penalties were misclassified for medical facilities in the readmissions program for 2019. The authors utilized 2014-17 information from CMS Hospital Compare website. The information consisted of details from 1,633 healthcare facilities that released Medicare recipients with heart attacks, 2,626 hospitals for heart failure and 2,705 healthcare facilities for pneumonia. Medical facilities were included if they had at least 25 discharges per condition..

The authors found the percentage of healthcare facilities that should have been penalized however werent was 20.9 percent for cardiac arrest, 13.5 percent for cardiac arrest and 13.2 percent for pneumonia. Vice versa, 10.1 percent were improperly penalized for cardiac arrest, 10.9 percent for cardiac arrest and 12.3 percent for pneumonia.